BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 3123967 · Received May 17, 2013

    Report

    Report Number
    1720753-2013-06144
    Event Type
    Malfunction
    Date Received
    May 17, 2013
    Date of Event
    May 6, 2013
    Report Date
    May 17, 2013
    Manufacturer
    GE OEC MEDICAL SYSTEMS
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REP PERFORMED AN ONSITE INVESTIGATION. THE LEMO CONNECTOR WAS REPLACED. THE SYSTEM WAS THEN FOUND TO BE OPERATING AS INTENDED.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE IMAGE BECAME GRAINY, THEN HALF OF THE SCREEN WENT BLACK, WHILE THEY WERE TAKING IMAGES. THIS RESULTED IN A LOSS OF LIVE IMAGE. THERE IS NO REPORT OF PATIENT INJURY ASSOCIATED WITH THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    218637 9900 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS 9900

    Patients

    Seq Age Sex Outcome Treatment
    1